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< Red

Bone conduction legend for right ear

> Blue

Bone conductrion legend for left ear


After the TM is perforated and surgery is done...
when it heals how many layers does it have?
***epithelium layer and the mucous layer
Can't make the fibrous layer again

4,000 hertz

Noise exposure that causes trama is around how many hertz on the graph?


How many types of hearing loss are there?


How long is the ear canal?

Abnormal, 15db

A person with MHL has what type of air and bone conduction thresholds?
________ bone conduction + Air conduction but there is at least a _____ gap.
*****For example a patient may come in a first time and find out he has a sensorineural hearing loss due to presbycusis. Then maybe he perforates his tympanic membrane with a q-tip. Now the audiogram will show the difference.

Adult case history example

1.Do you ever have: Ringing? ___Dizziness?________ Drainage? _____ Full feeling? __ Ear pain________
2.Is there a family history of hearing loss? ________________________________________
Which family members?_______________________________________
3.Have you ever been exposed to loud noise? ______________________________________
When?____What Type?_________How Long_______
4.Have you ever had any of the following:
Meningitis_____, Scarlet Fever_____,Mumps_____, Measels_____, Diabetes_____
5.Did you have an illness or accident at the onset of your loss?____________________
If so, what?


What type of conduction uses ear/headphones during testing?

Air and Bone Conduction

What are the two pathways/methods that humans hear through?

Air bone conduction

We use both _____ and _____ __________ to together to find out what determines the nature/type of hearing loss one has. By reading an audiogram and comparing Bone v.s. Air conduction you can tell the type of hearing loss and its degree.

air born radiation

During a bone conduction test sound may come out and reach the inner ear Via the EAM. This is called _____ ______ _________
This is when masking is done.

Air conduction

*Sound passes through the ear canal to the inner ear

Apgar Scale

* This scale evaluates newborns hearing
*By 10 minutes they need to have a score of 7 or better
* If the score is less than 7 they may have hearing loss


register hearing test by introducing pure tones & determine the minimal level a patient can hear a signal.


______________ is a branch of medicine called paramedical

Audiometric Legends

Air conduction Bone conduction
O Right ear < Right ear
X Left ear > Left ear


What color of headphone goes into the left ear?

Bone conduction

*When a signal is heard via bone.
sound bypasses the ear canal and goes directly to the inner ear via the bones of the skull (temporal and mastoid bone)
* We hear our own voice mainly through bone conduction.

Bone conduction device

transducer converts electic signals into sounds- Place device on either temporal bone or mastoid bone and send the signal. This can be in the form of a bone vibrator or a tuning fork.


While do a case history which set of questions should you ask. open, closed or both?

can hear

Reading the audiogram-below the line

can't hear

Reading the audiogram-above the line

Case History

Questions asked to get a better understanding of what may be wrong with the patient.
Questions on: background, history, family history

Case history

What is the first evaluation an audiologist should administer?
They should do a _________ _________

clear path

Why do you use a otoscope?
* Not to diagnose, but to see if there is a ________ _______ for hearing.

Closed set

* Questions that you prepared. You may combine closed set questions with open ended.

conductive hearing loss

*related to the damage, pathologies, or abnormalities of the external or middle ears, or both
*No permanent damage-mechanical problem-hearing will come back in most cases-medically manageable


What do professionals use to remove cerumen from the ear canal?
________ aka wax spoon


What does an air conduction test tell us about hearing?*Tells us the _________ % of hearing loss


Why is it important to do a case history on a patient?
It helps make a better ___________.

Frequency scale

*Goes from low to high Hz

hasn't been asked

What is an important question to ask when doing a case study?
Is there anything else you would like to mention that __________ _______ ________? (open set question)

hearing loss

5 major types of _________ _______
1. Sensorineural hearing loss
2. Conductive hearing loss
3. Mixed hearing loss
4. Central auditory dysfunction
5. Non-organic hearing loss (pseudohypacusis)

Horizontal, Frequency

what are the two scales of the audiogram?
1. __________ Line - db
2. _________ scale - Hz

Horizontal Line

*loudness of sounds-dB hearing loss
** Unit is dBhl
*** Softer the sound the closer to zero
*** Louder the sound the closer to 100


partial hearing loss

infections, fluid

What are some causes of CHL?
*wax in the ear canal
* perforation of the TM
*abnormalities in the middle ear
*_______ in the middle ear
*atresia (closure of the ear canal)

low and back

To look in an adults ear using an otoscope, how do you pull the ear?


*___________perforation on the TM
perforation is on the side of pars tensa-harder to heal than center perforation
Central perforation of TM - In center, pars tensa. easier to heal after surgery.
Pars flaccida perforation: aka "atic perforation": very dangerous.
Total perforation: Complete perforation of TM. Not able to fix or heal. Not congenital. Can be caused by middle ear disease.

Mixed hearing loss

*combination of SNHL and CHL

mixed hearing loss

What are some examples of __________ ____ _____?
*Person who has prebycusis and was cleaning ear out and happened to rupture the TM.
*A child with Rubella who develops a middle ear infection

mumps, tumor

What are some causes of sensorineural hearing loss?
* person who has had ________
* because of presbycusis
*noise exposure
*beign _________
*medications (ototoxia-lead)


What does a bone conduction test tell us about?
* It determines the ______/______ of hearing loss or site of lesion.

normal, abnormal

A patient with CHL has what type of air and bone conduction thresholds?
bone conduction-________
air conduction-________

Open set

* Questions from the top of your head-anything that comes to mind

Open set, closed set

What are the two types of questions that can be asked during a Case History?


*Inspection of the ear-look inside the ear canal using a tool called the otoscope
*look for
TM intact (Malleus? Cone of light? Umbo? coloration pearl-like?

patient's family

In a case history study, what types of problems in the _____________ ____________ are it important to know about?
Thyroid Problems
High Blood Pressure
All of which may cause hearing loss


____________ Questions-examples
* During birth or at birth (during the birthing process)
*Was there anoxia (lack of oxygen)?
*Was the child pale?
*Did the child have enough muscle tone?
*Was the Apgar scale low?
*low birth weight?


___________ questions-examples
* After birth
* Has anyone smoked in the house while the child was in the room?
* Does the child have noisy toys?
*Was the child's birth weight less than 1500grams?
* Was the child in NICU?
*Was the child full term or premature?
*Was the child born naturally or c-section?


_____________ questions-examples
*Before birth, during pregnancy
*Did the mom have Rubella?
*Did the mom use drugs or alcohol?
*Was there an accident or some kind of trauma?

prenatally, perinatally, and postnatally

What are important questions to ask for a child's case history?
*ask the parents
* ask questions ____________ __________ ___________


hearing loss because of advanced age


vision loss because of advanced age


What color of headphone goes into the right ear?

Red Round Right

Air conduction legend for right ear
RRR- ________ _______ _______ - O red

rupture their TM

When using an otoscope on a child how should you hold their head? Why?
*parent should embrace child and put their hand on their child's head, so the child doesn't move and __________ _____ ____


The ear canal is like a shallow ____.


A patient with SNHL has what type of air and bone conduction thresholds?
they are the ________ or similar

save their hearing

Sudden hearing loss V.S. gradual hearing loss
Sudden hearing loss can be managed if treated quickly-there is more of a chance to _______ ______ _______
*Sudden -just happened
*gradual-over time


____________ hearing loss
*the most common type of hearing loss
*due to the damage or the cochlea or hearing nerve-or beyond(inner ear or beyond)
*called this because it has both a sensory + neural component
*sometimes can be just sensory or neural
*But can also be both


* minimum level a person can hear

This is called their hearing __________

threshold, hearing loss

The _________of bone and air conduction tells us the nature/type of ____________ ______. As well as the degree.


The audiogram has ________scales.

up and back

To look in a childs ear using an otoscope, how do you pull the ear?


*A device the connects to the otoscope to look inside the ear-it can be seen on a screen-great for teaching.

X and Blue

Air conduction legend for left ear

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